Benign multicystic peritoneal mesothelioma: literature review and update

Our plain-English summary of Benign multicystic peritoneal mesothelioma: literature review and update, by M.T. Chand, J. Edens, T. Lin, et al (Autopsy & Case Reports, 2020).

The study

• Authors: M.T. Chand, J. Edens, T. Lin, I. Anderson, R. Berri
• Journal: Autopsy & Case Reports
• Published: 2020;10(3):e2020159
• Type of article: Case report
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumor diagnosed predominantly in pre-menopausal women. Associated risk factors include endometriosis and pelvic inflammatory disease in women, and prior abdominal surgery in both genders. To date, the pathogenesis of this disease remains controversial with possible etiologies, including a neoplastic versus a reactive process. Given the risk factors, some authors believe that this disease is secondary to a reactive process. However, because some studies describe cases where there is no prior surgical history or inflammatory milieu present, and because of this entity's predilection for recurrence, some authors believe the origin to be neoplastic. Some genetic and familial associations have also been reported. Malignant transformation is extremely rare, with only two cases reported in the literature, despite the recurrence potential. Like the etiology, the name of this entity is also controversial. Some authors prefer the term "peritoneal inclusion cyst (PCM)" instead of "benign cystic mesothelioma" and argue that the term mesothelioma should only be used when there is evidence of atypia. Most cases of BMPM are discovered incidentally. Others reflect sequela of tumor mass effect. It appears intra-operatively as large, multi-focal, cystic lesions in the peritoneal and pelvic cavity. Diagnosis is achieved through surgical sampling with histopathological examination. Immunobiologically, BMPM exhibits multiple small cystic spaces with flattened lining containing calretinin positive cells without atypical features, mitotic figures, or tissue invasion. Treatment includes cytoreductive surgery. Here we present a case of BMPM in a 60-year-old male - a rare disease in an uncommon patient population.

Autopsy and Case Reports. ISSN 2236-1960. Copyright © 2020.

In plain English

This article reports one patient's case and discusses earlier work on benign multicystic peritoneal mesothelioma (BMPM), a rare tumor of the abdominal lining. A 60-year-old man went to an emergency department with right flank pain. A non-contrast CT found a stone in the right ureter and, by chance, a 7.9 x 9.6 cm multi-lobulated cystic mass behind the bladder. After the stone was treated, a contrast-enhanced CT confirmed the mass and showed additional cystic lesions in the right colonic gutter. Tumor markers CA-125, CA19-9 and CEA were within normal range. Surgical specimens showed many small cysts lined by bland, flattened mesothelial cells without atypia or invasion. The cells stained positive for calretinin and negative for Ber-EP4, which the authors described as consistent with BMPM. He was treated with tumor debulking and hyperthermic intraperitoneal chemotherapy (HIPEC), and the authors reported that he was in remission. The article does not describe his asbestos exposure history. Citing earlier reports, the authors stated that, unlike pleural mesothelioma, BMPM has not been associated with asbestos exposure, and that its treatment remains controversial.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of a single patient, followed by a discussion of previously published literature
• Who was studied: One 60-year-old man treated at Ascension hospitals in the Detroit, Michigan area, USA. Dates of care are not given.
• Exposure: No asbestos or other exposure was studied or reported for this patient. In the discussion, citing an earlier report, the authors stated that BMPM, unlike pleural mesothelioma, has not been associated with asbestos exposure.
• Main results:
  • In this patient, a non-contrast CT done for a ureteral stone incidentally found a 7.9 x 9.6 cm multi-lobulated cystic mass behind the bladder.
  • After the stone was treated, a follow-up CT with intravenous contrast confirmed the mass and showed additional cystic lesions in the right colonic gutter.
  • The patient's tumor markers CA-125, CA19-9 and CEA were within normal range.
  • The patient's surgical specimens showed many small cysts with bland, flattened mesothelial lining, without atypia or invasion.
  • The patient's tumor cells were positive for calretinin and negative for Ber-EP4, which the authors described as consistent with BMPM.
  • The patient was treated with HIPEC and tumor debulking, with removal of the cystic abdominal and pelvic lesions.
  • The authors reported that the patient was in remission at the time of writing.
• The authors' conclusion: The authors presented the case as BMPM in a 60-year-old man, which they called a rare disease in an uncommon patient population. They stated that the treatment of this condition remains controversial.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Malignant Transformation, Etiology, Mesothelioma, Sequela, Calretinin, Cytoreductive Surgery.

Related studies

• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature — S. Gussago, P. Spina, et al. (2019)
• A recurrence of benign multicystic peritoneal mesothelioma treated through laparoscopic excision: a case report and review of the literature — T.D. Witek, J.W. Marchese, et al. (2014)
• Benign multicystic peritoneal mesothelioma treated with laparoendoscopic single site surgery: a case report and review of the literature — K.S. Cha, Y.H. Choi, et al. (2018)
• Benign Multicystic Peritoneal Mesothelioma in a Male Patient with Previous Wilms' Tumor: A Case Report and Review of the Literature — G.L. Canu, F. Medas, et al. (2018)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain: a case report and review of the literature — H.B. Hassine, M. Touati, et al. (2025)

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